I Overcomplicated Medicare Advantage (And Found a Simple Fix That Worked) — Fady Sahhar
Release Date: 07/01/2025
Home Care Hindsight
Fady Sahhar, a disability advocate and home care strategist with decades of experience, unveils how Medicare Advantage is reshaping home care—and why agencies must rethink caregiver training to thrive. In this eye-opening conversation with host David Knack, Fady shares: Why 750+ Medicare Advantage plans now cover home care (and how to tap into this growing market). The "lifetime value" mindset shift that turns clients into long-term partners. How peer coaching solves EVV resistance and caregiver retention challenges. Fady also reveals common cultural blindspots when expanding into new...
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Bruce Vanderlaan, seasoned investment banker and home care M&A expert, reveals how control-freak tendencies can sabotage agency growth, and why letting go is the key to unlocking real value. In this candid conversation with host David Knack, Bruce shares hard-won lessons from decades of guiding home care owners through exits, including: The financial metrics buyers actually care about (and why "too profitable" can be a red flag). How over-control devalues your agency—and how to fix it. The surprising role of culture in maximizing your sale price. Bruce also dives into common...
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Jensen Jones, CEO of Home Care CEO, opens up about the surprising mindset shift that reshaped his entire business model from an “exclusive” high-revenue think tank to a values-driven, mission-aligned community. In this candid conversation, Jensen and host David Knack explore how aligning personal values with business decisions can radically improve culture, retention, and growth. Jensen reflects on how his father's illness helped define his core values and how he now helps agencies scale without losing their humanity. He reveals the dangers of over-customizing roles, why playbooks prevent...
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Dr. Greg Sanchez, a former pharmaceutical scientist turned Home Instead franchise owner, shares how rapid growth nearly derailed his business, and the policies that saved it. From evacuating bedbound clients during wildfires to securing $400K in training grants, Greg reveals how to scale without sacrificing stability. Learn why overtime below 2% is possible, how to hire schedulers who thrive on chaos, and why the "gray market" of private caregivers threatens the industry. In this episode, you’ll discover: 1. The hidden costs of growing "at all costs" and how to avoid bankruptcy. 2....
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John Bennett, CEO of DLEM Holdings, reveals how his obsession with data nearly stalled his multi-agency empire—until one accidental escape room outing reignited growth. In this heartfelt episode, John shares how culture saved his business, what he learned from six acquisitions (including one that led to an FBI raid), and the systems that allow his team to thrive across five states. From team rituals and storytelling to onboarding playbooks and Zingage gamification, John maps out how he’s scaling connections without losing control. In this episode, you’ll discover: 1. The three types...
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Aaron Marcum, home care industry titan and founder of Breakaway365, reveals how his obsession with control nearly destroyed two companies—and how Martin Seligman’s positive psychology transformed him into a leader who scaled his business *while taking 8-week sabbaticals*. In this raw conversation, Aaron dismantles toxic myths about turnover and "balance," shares why presence beats perks for loyalty, and delivers a science-backed framework for building self-multiplying teams. In this episode, you’ll discover: 1. How Aaron almost abandoned Home Care Pulse mid-study—and the 8-month hunt...
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Todd Allen, CEO of AxisCare, shares how a personal caregiving experience led him into the home care technology space and the transformative mindset shift that changed his leadership approach. In this conversation with David Knack, Todd unpacks what “play to win” means in home care, why AI needs cautious adoption, and how proactive health habits (for you and your caregivers) can transform outcomes. In this episode, you’ll discover: 1. Why AxisCare started as an internal tool—and how it grew into a mission-critical SaaS for agencies. 2. The hidden risk of perfectionism in business and...
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Jeremy Fuller, a digital marketing expert with 23 years of experience and founder of Grow Senior Care Marketing, shares actionable insights for home care agencies. In this episode, you’ll discover: 1. The ChatGPT Surprise: How a client found their agency through ChatGPT—without it being a marketing goal. 2. The $500 Mistake: Why most home care agencies waste 80% of their Google Ads budget (and how to fix it). 3. Automation Pitfalls: The dangers of over-automating caregiver recruitment and how to strike the right balance. 4. SEO Myths Debunked: Why tracking rankings isn’t SEO—and...
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Krystal Wilkinson, owner of a 4-location home care agency in Arizona, shares hard-won lessons from 13 years in the trenches. In this episode, you’ll discover: 1. The $250,000 Mistake: How holding onto toxic employees cost her top performers (and how to spot the red flags earlier) 2. The "Golf Cart Law" Effect: How advocating for seniors’ safety became a unexpected business growth lever 3. Caregiver Shout-Outs That Stick: The Wednesday ritual that boosted retention (including a 17-year employee) 4. From Theater Major to Home Care CEO: Why her Broadway background makes her a better leader...
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Christina Chartrand, SVP of Training at Senior Helpers, reveals why companionship is the unspoken "glue" of home care—even if no one pays for it directly. In this episode, she shares: 1. The sugarcoating mistake that backfired with new franchisees (and how brutal honesty builds better owners) 2. Why puppetry skills translate to dementia care (plus her past life as a professional puppeteer) 3. The 3-year rollercoaster rule—why early chaos is normal (and when it stabilizes) 4. Age-Friendly Care certification—how Senior Helpers is redefining senior independence Lesson Takeaways: 1....
info_outlineFady Sahhar, a disability advocate and home care strategist with decades of experience, unveils how Medicare Advantage is reshaping home care—and why agencies must rethink caregiver training to thrive.
In this eye-opening conversation with host David Knack, Fady shares:
- Why 750+ Medicare Advantage plans now cover home care (and how to tap into this growing market).
- The "lifetime value" mindset shift that turns clients into long-term partners.
- How peer coaching solves EVV resistance and caregiver retention challenges.
- Fady also reveals common cultural blindspots when expanding into new markets, the underrated power of back-office customer service, and why "nothing about us without us" should guide every disability interaction.
In This Episode, You’ll Discover:
- Medicare Advantage 101: Reimbursement rates, local plan strategies, and why home care beats home health for post-discharge recovery.
- The "Wheelchair Lesson": How to interact with clients with disabilities (hint: sit down first).
- Rural vs. Urban Care: Why training must adapt to community rhythms—not just policies.
- Peer Coaching Magic: How top caregivers can train teams better than supervisors.
- Data = Negotiation Power: What payers really want from home care agencies in value-based contracts.
Lesson Takeaways:
- Medicare Advantage is a gateway. Reimbursement sits between Medicaid and private pay—but the real value is in lead generation and proving outcomes.
- Train caregivers as local experts. Your processes stay consistent, but training must reflect community needs.
- Peer coaches over policy manuals. Let star caregivers demonstrate EVV or crisis response—it’s 10x more effective.
- Track client health like a CRM. Preventing UTIs or hospitalizations is your leverage with payers.
- "Nothing about us without us." Involve clients with disabilities in designing their care.
Timestamps:
00:00 – Welcome to Home Care Hindsight
01:50 – Fady’s intro: Wheelchair user, quadri-lingual, and advocate
03:10 – How to interact with clients with disabilities (the "pull up a chair" rule)
05:25 – Medicare Advantage’s home care boom: 750+ plans and counting
08:30 – Why home care beats home health for post-discharge recovery
12:15 – Fady’s biggest mistake: Treating all clients as homogeneous
16:40 – Rural vs. urban care: Why training must adapt to local culture
20:50 – Peer coaching: How star caregivers can train teams (EVV success story)
25:30 – Underrated #1: Back-office customer service as a differentiator
29:45 – Underrated #2: Proving outcomes to payers (data = $$$)
33:20 – Little mistake: Ignoring client lifetime value (and how to fix it)
36:00 – Fady’s proudest win: Agencies embracing value-based care
38:10 – Final thoughts: Plugging The VBP Blog and Dual Eligible HQ
Quotes:
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"If you’re standing next to someone in a wheelchair, pull up a chair. Talk to them—not their companion." — Fady Sahhar
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"Medicare Advantage plans don’t need a nurse to help someone get dressed. They need a caregiver at half the cost." — Fady Sahhar
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"Peer coaches make EVV adoption feel like help—not surveillance." — Fady Sahhar
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"Your caregivers are your eyes and ears. Train them to spot UTIs before ER visits happen." — Fady Sahhar
Resources:
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Connect with Fady Sahhar on LinkedIn: https://www.linkedin.com/in/fadysahhar/
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ProVantaCare Website: https://provantacare.com/
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The Value-Based Payment Blog: www.theVBPblog.com
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Dual Eligible HQ: www.DualEligibleHQ.com
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Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/
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Connect with Zingage on LinkedIn: https://www.linkedin.com/company/zingage/
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Powered by Zingage: https://zingage.com/
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Watch Episode on Zingage’s YouTube: https://www.youtube.com/@Zingage